Katano Takehiro, Sakamoto Yuki, Kunugi Shinobu, Nishiyama Yasuhiro, Shimizu Akira, Kimura Kazumi
Department of Neurology, Nippon Medical School Hospital.
Department of Pathology, Nippon Medical School Hospital.
Rinsho Shinkeigaku. 2020 May 26;60(5):340-345. doi: 10.5692/clinicalneurol.cn-001400. Epub 2020 Apr 18.
A 88-year-old man suddenly presented with aphasia and right hemiparesis. The diffusion-weighted image of MRI showed ischemic lesions on the left middle cerebral artery area, and MRA showed the left intracranial artery (ICA) occlusion. Therefore, we diagnosed him as having acute ischemic stroke and treated with mechanical thrombectomy (MT). The DWI of MRI showed ischemic lesions on the left middle cerebral artery area, and MRA showed the left ICA occlusion. Therefore, we performed MT and continued best medical treatment, but ICA was reoccluded. Six day later, aspergillus was found in the thrombus from ICA. Then, we considered that ICA occlusion was caused by aspergillus. We experienced a patient specified the cause by thrombus pathology. The pathological diagnosis of the thrombus getting by MT is usefulness for stroke etiology.
一名88岁男性突然出现失语和右侧偏瘫。MRI的弥散加权成像显示左侧大脑中动脉区域有缺血性病变，MRA显示左侧颅内动脉（ICA）闭塞。因此，我们诊断他为急性缺血性卒中并进行了机械取栓术（MT）治疗。MRI的DWI显示左侧大脑中动脉区域有缺血性病变，MRA显示左侧ICA闭塞。因此，我们进行了MT并继续给予最佳药物治疗，但ICA再次闭塞。六天后，在ICA的血栓中发现了曲霉菌。然后，我们认为ICA闭塞是由曲霉菌引起的。我们遇到了一名通过血栓病理学明确病因的患者。MT获取的血栓的病理诊断对卒中病因学有用。
